Houston Fertility Journal

There are a boundless number of old wive’s tricks to try for one gender or the other -- from position, to timing, to even what you eat -- people have been trying to take matters into their own hands since just about forever. But with modern advancements in reproductive medicine, the possibility of being able to select the gender of your child is now a reality.

Sperm-sorting technology has been used on animals for over 20 years. And because of advances in fertility treatments, doctors are able to identify male and female embryos. Though nothing can be one hundred percent guaranteed, gender selection is an option that often comes up when couples are considered high risk or concerned they will pass on genetic disorders to their children.

Though some families who are concerned with ‘family balancing’ (those who have children that are all one gender and wish to conceive one of the opposite sex) have also become interested in this technology. With gender selection, many are conflicted about when it is and is not appropriate. With our scientific knowledge these days, when is it necessary to use these tools, and when might they ultimately end up creating issues?

If you’ve done gender selection research on the internet, you have most likely found many tips and theories about things you can do at home that could possibly have some effect. A lot of the material you read online is misleading (especially when it comes to medical information) so take care and talk to experts you can trust.

The most successful methods are expensive and you will have to fulfill certain requirements depending on the clinic. In these methods, you will undergo the usual steps of in vitro fertilization along with the sorting of the sperm.

The Science Behind It All

The gender is based on which sex chromosome the sperm is carrying. The female only produces “X” chromosomes, so if the sperm is carrying a “Y” chromosome and it combines with the female’s “X,” a male will me made. A sperm carrying an “X” chromosome will combine with the female’s “X,” to produce a female embryo. Sperm separation allows the majority of the sperm carrying the chromosome of the desired gender to discover and hopefully make contact with the female egg.

The Methods of Gender Selection

There are two scientifically demonstrated methods which enable the selection an embryo’s sex possible. First a preimplantation genetic screening (PGS) will be done.This is to test the female’s embryos for aneuploidy (embyros with the wrong number of chromosomes). After screening the embryos, the quality of pregnancy may be improved as the chromosomes with possible abnormalities or undesired characters (such as gender) can be filtered out.

Next, the patient will undergo preconception sex selection (PSS), which is the actual process of attempting to manipulate the gender of the baby. Originally this process was created for couples involving an individual carrying an X-chromosome linked to a genetic disorder. In those cases, doctors make the offspring female so the disorder will not have a chance of being passed along. This method has been proven to be one of the safest and most effective based on ongoing clinical trial results.

Also, a study on a group of American’s attitudes toward PSS concluded that “most participants strongly favor PSS to avoid X-linked genetic diseases. Although some participants were uncomfortable with the use of PSS for non-medical sex selection, believing it to be ‘selfish’ and inconsistent with parental love, they did not perceive the potential harms to be significant enough to warrant governmental intrusion into reproductive decisions.”

Experts and Ethics

When PGS and IVF are used to avoid making a child with a genetic disease, the risks of the procedure are weighed and balanced against avoiding the transfer of the disease. This tends to make the highly invasive and expensive process worth it for some. In the American Society for Reproductive Medicine’s report on sex selection, the use of gender selection when there are no medical issues is “not encouraged” and it could create “social harm” and “gender bias.” The report points out these concerns, yet also acknowledges families hoping for a variety of genders in their family is a personal decision and not something to be controlled by the government based on their “constitutionally protected reproductive liberty”.

Yet, experts are still concerned about the ethics. In Bonnie Steinbock’s report on sex selection she points out that “parents who are sufficiently concerned to balance the sex of their offspring and seek IVF and PGS may be motivated by discrimination attitudes toward a particular gender.” People on the opposing side of sex selection worry about what it would do to the ‘natural balance’ of males and females. In a Cleveland State University study 94% of parents favoring sex selection said they would want their first born to be a son.

While considering your personal situation and the options at hand, it is important to know you are making decisions in the best interest for your family. As noted in the American Society for Reproductive Medicine’s report, if you are undergoing IVF gender selection based on medical issues, risks are already involved and you and your doctor have decided they are worth it. If you don’t initially have medical issues, is choosing your child’s gender important enough to outweigh the other considerations?